From 2005-2013, an average of 22% of high school students who reported ever having intercourse had been tested for HIV. A slightly larger portion of sexually active female students were tested compared to male students (27% versus 17%, respectively), reported Michelle Van Handel, MPH, of the CDC in Atlanta, and colleagues.

The numbers were slightly higher among young adults, although 33% of adults, ages 18-24, reported being tested for HIV from 2011-2013, they wrote in Pediatrics.

Among high school students, the portion of students being tested for HIV was similar among those who reported having intercourse with at least one person person during the past 3 months (24%). Of those who reported having intercourse with four or more people, 34% had been tested.

While not involved with this research, Yvonne Maldonado, MD, of Stanford University in Palo Alto, Calif. said that the results were not surprising; since other studies have demonstrated missed opportunities for implementing CDC recommendations for HIV testing for all individuals, ages 13-69, and continued practice of risky sexual behaviors for HIV infection.

"It is incumbent on healthcare providers and public health systems to develop effective approaches to educating our youth regarding HIV testing and counseling, which are key methods to avoid this preventable and devastating infection," she wrote in an email to MedPage Today.

HIV testing among sexually active high school students was the most prevalent among black females (36%) and the least prevalent among white males (15%).

But prevalence of testing among young adults actually declined over the course of 2 years. Van Handel's group reported significant decreases in HIV testing prevalence among young adult females from 2011-2013 (42.2% to 39.5%, β= -0.06, P=0.02), with an almost 10 percentage point drop among young black females (68.9% to 59.9%, β= -0.20, P=0.02).

There was no significant increase reported in the prevalence of testing among young adult males, which the authors describe as concerning because both young adult males and young black females "account for the majority of new HIV infections among persons ages 13-24 years."

Among young adults who had been tested, 40.5% were tested at a private doctor's office/health maintenance organization, followed by 31.2% at a clinic and 13.6% in an "other setting."

Researchers examined data from an average of 14,675 students in grades 9 through 12 from all 50 states in the Youth Risk Behavior Survey, and 21,790 respondents from the Behavior Risk Surveillance System. The authors noted that the latter survey was limited to 2011-2013 data due to methodological changes that could affect assessment of HIV testing trends.

Limitations included the cross-sectional design of the Youth Risk Behavior Survey (the Behavior Risk Surveillance System sample is derived through random-digit-dial). The authors also noted that both surveys are self-reported. In addition, the gender of sexual partners was not included in the surveys, so the authors could not identify men who have sex with men, who account for the largest number of persons living with HIV infection.

The authors concluded that more provider education and system-based interventions -- such as adding blood tests to routine clinic visits for adolescents -- are needed. They recommend input from the American Academy of Pediatrics (AAP) and their Committee on Pediatric AIDS to better understand what would be involved in increased testing for adolescents with HIV.

"Multipronged testing strategies, including ... adolescent friendly testing services and sexual health education will likely be needed to increase testing and reduce the percentage of adolescents and young adults living with HIV infection," they wrote.

Van Handel and co-authors disclosed no relevant relationships with industry.

Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Accessibility Statement

At MedPage Today, we are committed to ensuring that individuals with disabilities can access all of the content offered by MedPage Today through our website and other properties. If you are having trouble accessing www.medpagetoday.com, MedPageToday's mobile apps, please email legal@ziffdavis.com for assistance. Please put "ADA Inquiry" in the subject line of your email.